Dr. Narendra Basarge

The problem of an enlarged prostate or benign prostate hyperplasia is a very common occurrence as you grow older. It's known to strike men above the age of 50, with more than 50% of men after the age of 60, having this complaint.

Causes of enlarged prostate

A non-cancerous condition, enlarged prostate makes the passing of urine from the bladder through the urethra difficult. The multiplication of the prostate cells causes an enlargement of the gland, leading to a buildup of pressure on the urethra, affecting the discharge of urine from the body. The narrowing of the urethra, due to this benign condition, forces the bladder to contract more vigorously so as to push urine out of the body.

As time passes, the muscles of the bladder get significantly affected, causing them to become extremely sensitive, thicker and stronger. As a consequence, the bladder begins to contract, even if the amount of urine in the organ is negligible, causing episodes of frequent urination. Gradually, the bladder fails to completely empty itself of urine due to the constriction of the urethra. This can give rise to a number of health problems including the formation of bladder stones, urinary tract infections, blood in the urine and so on.

Benign Prostrate Hyperplasia (BPH) is a condition which results in the enlargement of the prostate gland. The prostrate grand is situated near the Urethra (a tube which helps flush out the urine from the bladder). Generally, the chance of developing BPH increases after one crosses the age of 50. But it is yet unknown as to why some men experience more severe symptoms than others.

Causes of BPH
This condition generally occurs because of old age and affects almost all men above the age of 75. It occurs because of the various hormonal changes and changes in cell growth that the body goes through, as one becomes old. Sometimes BPH can set in due to genetics. If BPH sets in due to genetically reasons, it usually is quite severe and affects men before they reach 60.

Symptoms of BPH
Quite a few men who develop BPH, experience no symptoms at all. But when symptoms of BPH, known as lower urinary tract symptoms (LUT) start, they can be either mild or very severe. The severity of the symptoms is not related to the extent of the enlargement. Many a times men with only a mild enlargement complain about severe symptoms, while men with a highly enlarged prostate gland have not complained about any discomfort faced. 

Symptoms of BPH tend to worsen due to cold weather and also because of physical and emotional overexertion. There are certain medicines, which should be avoided if you suffer from BPH, as they have a tendency to worsen your symptoms, for example diphenhydramine, pseudoephedrine, oxymetazoline spray and other antidepressants.

The symptoms of BPH are related to bladder emptying and issues with bladder storage.

Symptoms related to the urine drainage from the bladder are:

1. Strain while urinating
2. Weak urine flow
3. Some dribbling after urination
4. Sudden urge to urinate
5. Pain while urinating

Symptoms related to storage of urine in the bladder are:

1. Waking during the night to urinate
2. Urinating frequently during the day and at night
3. Sudden urge to urinate, which may be hard to control

It however, has to be kept in mind that these symptoms may not primarily occur due to prostate enlargement, but are the result of other conditions like urinary tract infections, prostatitis, prostate cancer, neurological disorders and even diabetes. Thus, it is essential that you visit a doctor and get the cause for these symptoms diagnosed properly.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Here are a few things you should know about Testicular Cancer (TC): 

1. Age: The commonest affected age group is 20-45 years with germ cell tumours. Half of all cases occur in men less than 35 years. Non-seminomatous germ cell tumours (NSGCT) are more common at ages 20-35, while seminoma is more common at age 35-45 years. Rarely, infants and boys below 10 years develop yolk sac tumours and 50% men above 60 years with TC have lymphoma.
2. Race: White Caucasian people living in Europe and the US have the highest risk. Whites are three times more likely to develop TC than blacks in the US. With the exception of the New Zealand Maoris, TC is rare in non-Caucasian races.
3. Previous TC: Confers a 12-fold increased risk of metachronous TC. Bilateral TC occurs in 1-2% of cases.
4. Cryptorchidism: 5-10% of TC patients have a history of cryptorchidism. Ultrastructural changes are present in these testes by age 3 years, although earlier orchidopexy does not completely eliminate the risk of developing TC. According to a large Swedish study, cryptorchidism is associated with a two-fold increased risk of TC in men who underwent orchiopexy less than 13 year, but risk is increased 5-fold in men who underwent orchiopexy aged above13 years. A meta-analysis showed risk of contralateral TC almost doubles while ipsilateral TC risk is increased 6-fold in men with unilateral cryptorchidism.
5. Intratubular germ cell neoplasia (testicular intraepithelial neoplasia, TIN): Synonymous with carcinoma in situ, although the disease arises from malignant change in spermatogonia; 50% of cases develop invasive germ cell TC within 5 years. The population incidence is 0.8%. Risk factors include cryptorchidism, extragonadal germ cell tumour, atrophic contralateral testis, 45XO karyotype, Klinefelter's syndrome, previous or contralateral TC (5%), and infertility.
6. Human immunodeficiency virus (HIV): Patients develop seminoma 35% more frequently than expected. Genetic factors: appear to play a role, given that first-degree relatives are at higher risk by 4-9-fold, but a defined familial inheritance pattern is not apparent.
7. Maternal oestrogen exposure: At higher than usual levels during pregnancy appears to increase risk of cryptorchidism, urethral anomalies, and TC in male offspring.

Trauma and viral-induced atrophy have not been convincingly implicated as risk factors for TC. In case you have a concern or query you can always consult an expert & get answers to your questions!

Reproductive medicine has gained a lot of attention recently with its increasing scope and opportunity. This branch of medicine is concerned with improving reproductive health, preventing reproductive disorders, diagnosis of infertility issues and allowing couples to have children when they choose to be parents. The scope of reproductive medicine is based on endocrinology, anatomy and physiology. Here are some things you need to know about reproductive medicine:

Scope

Reproductive medicine includes many aspects of human health and other factors. Sexual dysfunction, puberty, birth control, sex education, family planning are some of the factors that it is concerned with it. In women, issues such as ovulation, menstruation, menopause and pregnancy are of immense importance in reproductive medicine.

Methods and techniques

Methods to assess any reproductive abnormality include reproductive surgery, laboratory methods while methods of treatment are prescription of fertility medication, counseling and surgery. In vitro fertilization or ivf has become one of the most effective treatments to enable pregnancy. This treatment allows the examination of the embryo before implementation.

Training

Specialists in reproductive medicine are trained in gynecology and obstetrics which is followed by infertility and reproductive endocrinology. Some of them specialize in urology followed by andrology. Training is also provided for contraception specialization. Usually, specialists in this branch of medicine receive education in particular organizations that deal with only human reproductive disorders. Consult an expert & get answers to your questions!

Bladder cancer is characterized by irregular growth of abnormal tissue (tumor) on the lining of the bladder. This type of cancer may spread to the surrounding tissues or other body parts as well.

What are the causes?

Bladder cancer can be caused by environment-related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. It may also be caused by continuous exposure to chemicals such as dyes or leather dust and radiation. These chemicals tend to cause unusual changes in the cells of the bladder lining and causes cancer in the bladder.

It can also be caused by modifications in the dna in the cells of the bladder which may impair the functioning of the cells in the body. This can cause mutations in the bladder resulting in cancer.

What are the symptoms?

1. Presence of blood in the urine, often painless

2. Feeling of pain while passing urine

3. Back pain

4. Excessive urination

5. Infections in the urinary tract

6. Lower leg swelling

7. Pain in the bones, especially in the pelvic area

8. Weight loss

Treatment options

Treatments for bladder cancer depend on the stage of the cancer. The various treatment choices are:

Surgery - In some cases, these cancers are surgically removed by a surgeon. A type of surgery used is transurethral resection of bladder tumor (turbt) where the cancer cells are destroyed with laser by passing a thin fiber into the bladder.

Chemotherapy - In this method, medications are used to target and destroy cancer cells.

Radiation therapy - Radiation therapy uses rays such as x-ray or uv rays to destroy cancer cells in the body

Immunotherapy - This treatment boosts the immune system of the body so that it attacks the cancerous cells in the bladder. If you wish to discuss about any specific problem, you can consult a Urologist.

The condition in which blood appears in the urine is known as hematuria. The loss of blood in this condition could be gross or microscopic depending on the cause of the condition. There are several causes why blood may appear in the urine. Whatever the cause may be, hematuria is mostly indicative of a serious medical condition.

Here are 5 reasons that cause blood to appear in the urine.

1.Infection

Infections like urethritis, pyelonephritis, cystitis or infection in any other body organ along the urinary tract is one of the most common causes of hematuria. Such bacterial infection in the urethra can also infect the kidneys and the urinary bladder. It results in the urge to urinate frequently and also causes blood to appear in the urine.

2. Kidney stones and bladder stones

Another reason that can cause blood to appear in the urine is the presence of stones in the kidney or bladder. These stones are crystallized minerals that are formed in the kidney or the bladder but fail to pass through the urinary tract. They cause blockage and pain and result in hematuria.

3. An enlarged prostate

An enlarged prostate is a common cause of appearance of blood in the urine in men who are in their middle ages or older. Enlargement of the prostate gland causes the urethra to be compressed. This prevents the urethra from getting fully emptied while urination.

4. Polycystic Kidney Disease

PKD is a kidney disorder in which cysts filled with fluid form in the kidneys and impair the kidneys, causing them to fail entirely at times. It is an inherited disease and causes blood to appear in the urine.

In children who are between 6-10 years of age, kidney disorder after streptococcal glomerulonephritis can be a possible cause of hematuria.

5. Cancer

A cancerous kidney, bladder or prostate gland can also cause blood to appear in the urine. It is another major cause of hematuria but usually occurs in older patients. If you wish to discuss about any specific problem, you can consult a Urologist.

The prostate gland, an essential part of the male reproductive system grows throughout your life. As you grow older, it becomes imperative to keep this organ healthy.

Here's what you can do to maintain a healthy prostate:

1. Workout to stay fit - Exercising regularly and maintaining an optimum weight can help to keep your prostate gland at an optimal health. Several types of research have revealed the beneficial aspects of exercising. It's said that physically active men are less likely to suffer from enlarged prostate if they performed a physical activity of low to moderate intensity. Likewise, physically active men who ran for 90 to 108 minutes are 20% less likely to develop erectile dysfunction.

2. Eat fruits and vegetables - Including fruits and vegetables in your diet can help to maintain a healthy prostate. Guava, papaya, tomato and watermelon are some of the options that spell good for your prostate. Vegetables like cabbage, cauliflower, broccoli and Brussels sprouts should also be included to boost the health of the gland. Ideally, you should have about 5 servings of fruits and vegetables daily.

Our kidneys are an important organ in the body and are responsible for the filtration of blood and creation of urine. Sometimes, during this process salt and other chemicals get stuck together to form small crystals also known as kidney stones. The size of a kidney stone can range from the size of a sugar crystal to the size of a ping pong ball. However, it is noticed only if it is large enough to cause a blockage. Smaller stones may pass out of the body without you realizing it.

Kidney stones can be a very painful experience. Some of the symptoms exhibited by patients suffering from kidney stones are:

1. Severe back pain
2. Pain in the belly or groin
3. Painful urination
4. Frequent urination
5. Nausea and vomiting
6. Blood in the urine

Excruciating pain is usually the symptom that makes a patient consult a doctor in cases of kidney stone problems. A confirmed diagnosis can then be made by using a series of tests that include an X-ray, ultrasound, CT scan and urine analysis. A blood test may also be conducted to check the mineral levels in the body.

Kidney stones are a common condition faced by many people, but some people are at a higher risk of suffering from this than others. Some of these factors are:

1. Family history of kidney stones
2. High uric acid levels in the blood

Between men and women, the former are at a higher risk of suffering from kidney stones. Asians and Caucasians also suffer from this condition more than people from other races. Hormone changes during pregnancy can also trigger the formation of kidney stones.

The first thing to do if you suffer from a kidney stone is to increase your water intake. This can help dissolve some of the minerals in the stone and make it a small enough to pass through the urethra. Injectable anti-inflammatory drugs and pain relievers may be used to ease the pain caused by kidney stones.

If the kidney stone does not pass on its own, a process known as lithotripsy may also be used. This involves the administration of shock waves that can break a large stone into smaller pieces. In extreme cases, surgical techniques may also be used. However, Lithotripsy in only one of the ways of treatment and given in only selected cases nowadays. Better ways of treatment are: 

1. Ureteroscopy- seeing the stone through a long telescope through the urine passage and removing it.
2. PCNL- removing kidney stone by a small puncture into the kidney through the skin.
3. RIRS- visualising the stone in the kidney with a bendable telescope and breaking the stone using laser.

   If you wish to discuss about any specific problem, you can consult an urologist.

Be careful about kidney stones this summer.